Puig, NoemiPaiva, BrunoLasa, MartaBurgos, LeirePerez, Jose JMerino, JuanaMoreno, CristinaVidriales, Maria-BelenToboso, Dolores GómezCedena, Maria-TeresaOcio, Enrique MLecumberri, RamonGarcía de Coca, AlfonsoLabrador, JorgeGonzalez, Maria-EstherPalomera, LuisGironella, MercedesCabañas, ValentinCasanova, MariaOriol, AlbertKrsnik, IsabelPérez-Montaña, Albertde la Rubia, Javierde la Puerta, Jose-Enriquede Arriba, FelipeProsper, FelipeMartinez-Lopez, JoaquinLecrevisse, QuentinVerde, JavierMateos, Maria-VictoriaLahuerta, Juan-JoseOrfao, AlbertoSan Miguel, Jesús F2025-01-072025-01-072018-12-12https://hdl.handle.net/10668/26671Early diagnosis and risk stratification are key to improve outcomes in light-chain (AL) amyloidosis. Here we used multidimensional-flow-cytometry (MFC) to characterize bone marrow (BM) plasma cells (PCs) from a series of 166 patients including newly-diagnosed AL amyloidosis (N = 94), MGUS (N = 20) and multiple myeloma (MM, N = 52) vs. healthy adults (N = 30). MFC detected clonality in virtually all AL amyloidosis (99%) patients. Furthermore, we developed an automated risk-stratification system based on BMPCs features, with independent prognostic impact on progression-free and overall survival of AL amyloidosis patients (hazard ratio: ≥ 2.9;P ≤ .03). Simultaneous assessment of the clonal PCs immunophenotypic protein expression profile and the BM cellular composition, mapped AL amyloidosis in the crossroad between MGUS and MM; however, lack of homogenously-positive CD56 expression, reduction of B-cell precursors and a predominantly-clonal PC compartment in the absence of an MM-like tumor PC expansion, emerged as hallmarks of AL amyloidosis (ROC-AUC = 0.74;P enAdultAgedAged, 80 and overBiomarkersBone MarrowClonal EvolutionFemaleFlow CytometryHumansImmunoglobulin IsotypesImmunoglobulin Light-chain AmyloidosisImmunophenotypingMaleMass ScreeningMiddle AgedNeoplasm StagingRisk Assessmentresearch article30542145open access10.1038/s41375-018-0308-51476-5551https://dadun.unav.edu/bitstream/10171/56830/1/Paper%20AL%20amyloidosis%20LEUKEMIA%20MR%20CLEAN.pdf